Growlife Medical Terms and Conditions
Please read this consent form carefully prior to signing.
This general practice collects information from you for the primary purpose of providing quality health care. We require you to provide us with your personal details and a full medical history so that we may properly assess, diagnose and treat illnesses and medical conditions, ensuring we are proactive in your health care. To enable ongoing care, and in keeping with the Privacy Act 1988 and Australian Privacy Principles, we wish to provide you with sufficient information on how your personal information may be used or disclosed and record your consent or restrictions to this consent.
Your personal information will only be used for the purposes for which it was collected or as otherwise permitted by law, and we respect your right to determine how your information is used or disclosed.
The information we collect may be collected by a number of different methods and examples may include: medical test results, notes from consultations, Medicare details, data collected from observations and conversations with you, and details obtained from other health care providers (e.g. specialist correspondence).
By signing below, you (as a patient/parent/guardian) are consenting to the collection of your personal information, and that it may be used or disclosed by the practice for the following purposes:
• Administrative purposes in running our general practice.
• Billing purposes, including compliance with Medicare requirements.
• Follow-up reminder/recall notices for treatment and preventative healthcare.
• Disclosure to others involved in your health care, including treating doctors and specialists outside this medical practice. This may occur through referral to other doctors, or for medical tests and in the reports or results returned to us following the referrals.
• Accreditation and quality assurance activities to improve individual and community health care and practice management.
• For legal related disclosure as required by a court of law.
• For the purposes of research only where de-identified information is used.
• To allow medical students and staff to participate in medical training/teaching using only de-identified information.
• To comply with any legislative or regulatory requirements e.g. notifiable diseases.
• For use when seeking treatment by other doctors in this practice.
At all times, we are required to ensure your details are treated with the utmost confidentiality. Your records are very important and we will take all steps necessary to ensure they remain confidential.
Please complete the form below if you understand and agree to the following statements in relation to our use, collection, privacy and disclosure of your patient information.
By accepting our terms and conditions you agree to the following statement:
I have read the information above and understand the reasons why my information must be collected, and the purposes for which my information may be used or disclosed. I understand that if my information is to be used for any purpose other than that set out above, my further consent will be obtained.
I give my permission for my personal information to be collected, used and disclosed as described above (including contact via SMS to my mobile phone number). I understand only my relevant personal information will be provided to allow the above actions to be undertaken and I am free to withdraw, alter or restrict my consent at any time by notifying this practice in writing.
No Show/ Late cancellation Policy:
General and allied health medical appointments:
• 24 hour minimum cancellation. If you fail to give 24 hours’ notice you will be charged a fee of $89. This includes Shared Medical Appointments.
Specialist appointments:
• 48 hour minimum cancellation. If you fail to give 48 hours’ notice you will be charged a fee of $100.
These fees are an out of pocket expense and you are unable to receive a rebate from Medicare or private health funds.
We understand that there are times when you might miss an appointment and will be unable to call due to an unforeseen emergency. Please advise us by close of business and in this circumstance the fee will be waived.
Growlife Medical has implemented this policy in order to provide the best service to our clients. We need to be mindful of the time the health professional has set aside for you. For instance, when you do not call and cancel an appointment, you may be preventing another patient from receiving much needed treatment. Conversely, the situation may arise where another client fails to cancel and we are unable to schedule an appointment for you due to a seemingly “full” appointment book. Please understand that the intent of the policy is to aid us in offering a high standard of care to you, our clients, and that this policy is in place to help us achieve that goal.
We pledge to do our part to keep our schedule moving as efficiently as we possibly can.
We value you as a client and appreciate your understanding and cooperation.
By accepting our terms and conditions you agree to the following statement:
I acknowledge that I have read and understand this No-show/Late Cancellation Policy. I further understand that I will incur fees in the event I fail to give the required amount of notice before my scheduled appointment or if I fail to show up for my scheduled appointment. Any fees incurred are my responsibility to pay and in the event I incur a fee, such fee shall be paid prior to making any new appointment.